Name: Ensuring seamless medication transitions
Uploaded: 2024-07-09T05:42:23.814Z
Duration: 451.78
Description: Welcome to our insightful interview with Jo McMahon, an experienced embedded pharmacist at the Illawarra Retirement Trust Group. In this video, Jo shares her valuable insights and experiences from her role, highlighting the critical aspects of her work in aged care.

Jom m.mp4

Jom m.vtt

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So, trying to get a discharge

{{00:00:07}}
summary, trying to make

{{00:00:08}}
sure that you've got,

{{00:00:09}}
both sides of the page.

{{00:00:11}}
Sometimes we only get

{{00:00:12}}
every second page faxed.

{{00:00:14}}
We'll be looking to build

{{00:00:16}}
that information together,

{{00:00:18}}
to look at, how, Whether

{{00:00:22}}
there's things being

{{00:00:23}}
included on the discharge

{{00:00:25}}
summary that actually,

{{00:00:26}}
should have been weaned

{{00:00:27}}
at the end or, or ceased.

{{00:00:50}}
I have a background in

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hospital pharmacy and with the

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National Prescribing Service.

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I've also done some time

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with the Reduced Risk Group

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project and did a subsequent

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diploma of dementia care at

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the University of Tasmania.

{{00:01:04}}
So transition from hospital,

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what we're going to be looking

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at is the discharge summary.

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Hopefully, we don't always

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get one, but, if, if we,

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if we get it, I'll look

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at that and I'll also be

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looking at the medication

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chart to see exactly what's

{{00:01:21}}
been given, during the

{{00:01:22}}
admission, especially in

{{00:01:23}}
the days prior to discharge.

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If people are

{{00:01:26}}
coming from home.

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I'm going to be trying to

{{00:01:29}}
get information from the GP.

{{00:01:31}}
So a patient health summary.

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I want to know, what date of

{{00:01:36}}
last periodic injections was.

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I want to know what their

{{00:01:39}}
recent pathology was.

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What their vaccination

{{00:01:42}}
history is.

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And then try and

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put that together.

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often with a dispensing

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history from their

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local pharmacy, if

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I can identify it.

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And then try and, exactly

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reconcile all of those things.

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And then talk to

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the, to the resident.

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to get, information on,

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on what they see as their

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medication journey, what they

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actually take, what they like

{{00:02:04}}
to take, why they take it.

{{00:02:06}}
Okay, so, as, as before,

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we don't always get

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a discharge summary.

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you can actually Google, or

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not Google, but you can, you

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can go online and look at

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how your district, fares in

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the discharge summary race.

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In my area at the moment,

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we get less than 47 percent

{{00:02:25}}
from our ED departments.

{{00:02:28}}
So, trying to get a discharge

{{00:02:30}}
summary, trying to make

{{00:02:30}}
sure that you've got,

{{00:02:32}}
both sides of the page.

{{00:02:33}}
Sometimes we only get

{{00:02:35}}
every second page faxed.

{{00:02:37}}
We'll be looking to build

{{00:02:39}}
that information together,

{{00:02:41}}
to look at, how, whether

{{00:02:45}}
there's things being

{{00:02:46}}
included on the discharge

{{00:02:47}}
summary that actually,

{{00:02:49}}
should have been weaned

{{00:02:50}}
at the end or, or ceased.

{{00:02:52}}
whether therapeutic

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substitutions have

{{00:02:54}}
been, reversed.

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Whether, if fixed dose

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combination products have been

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separated, whether they've

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been put back together.

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so just trying to make

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sure that, what you get

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makes sense with what the

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resident, left you to go in

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the hospital on their list.

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I think the big thing is,

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our ability to be there or

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to have access to the notes.

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Five, five days a week,

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seven days a week.

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So we can, we can actually

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see what's happening.

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We can see if there's been

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a discharge summary posted.

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We can see if someone's

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been transported or

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gone to hospital.

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a basic thing is to try

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and make sure that the

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medication chart is as

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optimized as possible before

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any transaction, transition

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occurs, to make sure that the

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resident is given a copy of

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their medication chart to take

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with them wherever they go.

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That's, that's

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really important.

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and also the form of

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the medication chart.

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So, we can, we can get a

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med chart that is the chart

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of the day, but we can

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also get a summary chart.

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And sometimes that confuses

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hospitals because it'll

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have, a progression of

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what's happening with

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the, with the person's

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medication over a few weeks.

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So, it's, it's about working

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really hard to try and make

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sure the information is as

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simple, and easy as possible.

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And hopefully, the resident

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and their family have got an

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understanding about what's

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happening with medications.

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Because sometimes, in a

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hospital, all they need

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to do is ask the resident.

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A lot of residents know

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exactly what's going on.

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So they're there on the spot.

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I'm thinking of a gentleman,

{{00:04:35}}
who I look after, who has

{{00:04:38}}
had a fairly tough life,

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came to us, last year.

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We were able to optimize

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his medications, sort

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out his, his, analgesia,

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also started therapy for

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diabetes and heart failure.

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At that stage, he had a

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hospital admission, and when

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he came back to us, he was on

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all the drugs that he'd been

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on six months previously,

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at an earlier admission

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when he first came to us.

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So it was fairly obvious

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that the doctors had just

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looked at his previous

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list and had not updated

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anything that we'd sent.

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So they sent him home

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on the initial list.

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I was able to see that

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that didn't happen.

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that didn't look like what his

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chart should have looked like.

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and then just recently

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he's had another

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admission for sepsis.

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and during that admission he

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was sent back to us having

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had most of his medications,

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de prescribed, based on a

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goals of care discussion.

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When I went to visit him a

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couple of days after discharge

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and had a, had a sit down with

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him, that was not actually

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his understanding of the

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goals of care discussion.

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He was very unhappy in

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hospital, he wanted to get

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home, and he said what he

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thought he had to say to

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get out of the building.

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So, he'd, ended up with

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a medication list that

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was very different to

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what, what he expected.

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So, with discussion with

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the GP and with another

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goals of care discussion,

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John the resident has had

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his, medications reinstated

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as per his wishes.

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I think be available.

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value your credibility.

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advice I was given a long

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time ago when I started in

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hospital was, you don't have

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to give an answer right now.

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If you don't know the

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answer, tell, tell

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people you find out.

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I always try and value add.

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so whatever the relationship

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is, whether you're dealing

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with GPs, or you're dealing

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with nursing staff, or you're

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dealing with residents,

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hope that they'll leave

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the conversation knowing a

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little bit more than, than

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when, when they arrived

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at that conversation.

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And keep your eyes open

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because very often, you'll

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see things or people will

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tell you things, that you

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might not have been aware of

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if you, if you, if you don't

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get in there and have a, have

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a look on site and be there.

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And it's very often

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just chipping away.

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You make a little change

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and then you come back next

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week and you check where

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it's going and then you're

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able to feed back to the GP.

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You're able to talk to the

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resident if they're happy

{{00:07:19}}
and then you can keep on

{{00:07:21}}
tweaking those doses or, or

{{00:07:23}}
reducing drugs, deprescribing.

Pharmacy in aged care

Expert Insight

Welcome to our insightful interview with Jo McMahon, an experienced embedded pharmacist at the Illawarra Retirement Trust Group. 

In this video, Jo shares her valuable insights and experiences from her role, highlighting the critical aspects of her work in aged care.


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